Subtype and Stage Affect Mesothelioma Surgery Survival

Another study of mesothelioma treatments has confirmed that the best candidates for aggressive therapy, including radical surgery, are those patients who are in overall good physical condition and have the epithelial subtype of mesothelioma.

The new study followed 40 mesothelioma patients for at least 3 years. The goal was to evaluate what factors had the greatest impact on mesothelioma prognosis.  Each case was analyzed based on epidemiological factors, stage and subtype of mesothelioma, treatment method and complications, and other factors that influence patient survival.

Statistics

In keeping with the higher rate of mesothelioma in men worldwide, the ratio of men to women in the study was 13 to 1.  The average age of the patients was 55 and more than half of them (55%) had Stage I or II mesothelioma that was confined to the left side of the chest. The epithelial form was the most common type of mesothelioma in the study, effecting 62.5% of patients.

Treatment

Fifteen percent of mesothelioma patients in the study refused any type of treatment. Just over forty-seven percent were treated only with radiotherapy and chemotherapy. Of those who had mesothelioma surgery, 8 had the less radical pleurectomy with decortication and 7 had the more radical type of surgery including removal of a lung.

Survival

The average survival of the mesothelioma patients in the study was 10.5 months. Infection was the most common complication after surgery and one patient died from the surgery.  Patients who were in the best overall physiological condition before treatment and had early-stage epithelial mesothelioma appeared to have the best prognosis.

Conclusions

Based on what they termed the “low survival” after multimodality invasive treatments in mesothelioma, the authors of the study recommended that surgery be performed only on patients in good physical health, in early clinical stage, and with good pathology subtype.

Although one international group of doctors recently went so far as to suggest that radical mesothelioma surgery be abandoned because of its risk of complications other recent studies have suggested that new adjuvant therapies such as postoperative intrathoracic chemotherapy and photodynamic therapy can radically improve the chances of survival after mesothelioma surgery.

Source:

Bagheri, R et al, “Malignant pleural mesothelioma: clinicopathologic and survival characteristic in a consecutive series of 40 patients”, April 2011, Annals of Thoracic and Cardiovascular Surgery, pp. 130-136.